This paper traces the origins of the concept of personalisation in public sector services, and applies it to school education. The original conceptualisation stressed the need for 'deep' rather than shallow, personalisation, if radical transformation of services were to be achieved. It is argued that as the concept has been disseminated and implemented through policy documents, notably the 2005 White Paper, it has lost its original emphasis on deep personalisation. The focus in this article is particularly upon gifted and talented (...) students whose education provides the best case example of how the theory of personalisation might work in practice. Two examples of the lessons in a sixth form college are used to illustrate the character ofpersonalised pedagogy in practice. The implications for theory and practice are discussed. (shrink)

Personalised learning systems—systems that predict learning needs to tailor education to the unique learning needs of individual students—are gaining rapid popularity. Praise for educational technology is often focused on how technology will benefit school systems, but there is a lack of understanding of how it will affect the student and the learning process. By uncovering what the meaning of ‘personal’ is in educational philosophy and as embodied in the technology, we illustrate that these two understandings (...) are different regarding the autonomy of the student. Personalised learning technology, therefore, bears the risk of failing to achieve its educational ideal of what personalisation should be. We also illustrate how personalised learning technology effects student autonomy by requiring the intensive tracking of the learning process, exposing them to privacy and data protection risks. We do not claim that education does not need technology, but we want to illustrate the importance of values as drivers of innovation. (shrink)

This paper presents a ubiquitous learning system, the “Personalised Ubiquitous Learning Platform”, which integrates collaborative and social learning for the enhancement of the third level educational learning experience. University College Dublin provides its students with managed learning environments and adaptive learning via UCD Horizon which enables students to take different courses from different colleges throughout the university. The main objective of this platform is to complement the current MLEs with a single supported intelligent (...) and personalised ubiquitous learning environment that will promote and make provisions for adaptive and collaborative learning, human computer interaction on mobile and desktop clients anywhere and anytime. The system aims to enhance the students’ learning experience in third level educational environment by employing personalisation techniques such as the agent-oriented recommendation technique to engage students and help them access the content material for their studies. (shrink)

Personalisation is the new mantra in social care; this article focuses on how personalisation can be achieved in practice, by presenting an analysis of data from people with learning disabilities and their personal assistants, where traditional care relationships have often been shown to be disempowering. The focus here is on the ways in which both parties use references to shared knowledge, joint experiences or personal-life information. These strategies can be used for various social goals, and instances are given where (...) shared references are used during non task-related talk. Both parties are seen on occasion to attempt to refer to shared information, and dense layers of inference can result, which move the interaction onto an ordinary, more symmetrical and friendly footing. The article concludes that shared knowledge referencing creates a way to shift between the personal and the professional, to blur the boundaries, and to create a new and more personalised relationship. (shrink)

Learning about research ethics and research integrity is greatly facilitated by case studies, which illuminate, ground and personalise abstract questions. This paper argues that fiction can provide similar learning experiences, incarnating ethical dilemmas through a medium that is highly accessible yet sophisticated in its depictions of how researchers behave. Examples of fictional illustrations are given to illustrate various themes such as animal experimentation, exploitation of the vulnerable, researcher bias and research fraud.

Research Ethics, Volume 18, Issue 2, Page 114-125, April 2022. Learning about research ethics and research integrity is greatly facilitated by case studies, which illuminate, ground and personalise abstract questions. This paper argues that fiction can provide similar learning experiences, incarnating ethical dilemmas through a medium that is highly accessible yet sophisticated in its depictions of how researchers behave. Examples of fictional illustrations are given to illustrate various themes such as animal experimentation, exploitation of the vulnerable, researcher bias (...) and research fraud. (shrink)

‘Individualisation’ is a well-known societal phenomenon of late modernity. At the organisational level it shows up in different managerial forms and HRM technologies that focus more and more intensively on the employee as an individual person. In order to assess an employee’s personal contribution and commitment emphasis is put on the characteristics of individuals: their talents, performance and personality. Reporting on research on an individualised pay system in Denmark, this paper illustrates the empirical complexity of this personalisation process. It shows (...) how the employee is created and ‘codified’ as an individual person. It occurs in three different ways according to the codes of learning, love and the moral. It indicates that the postulated regime of individualisation follows a variety of trajectories to reach its target making for a quite subtle way of intimately managing human relations. (shrink)

Background Biomedicine, i.e. the application of basic sciences to medicine, has become the cornerstone for the study of etiopathogenesis and treatment of diseases. Biomedicine has enormously contributed to the progress of medicine and healthcare and has become the preferred approach to medical problems in the West. The developments in statistical inference and machine learning techniques have provided the foundation for personalised medicine where clinical management can be fully informed by biomedicine. The deployment of precision medicine may impact the (...) autonomy and self-normativity of the patients. Understanding the relationship between biomedicine and medical practice can help navigate the benefits and challenges offered by precision medicine. Methods Conventional content analysis was applied to “Le Normal and le Pathologique” (Canguilhem G. The Normal and the Pathological. Princeton: Princeton University Press; 1991) and further investigated with respect to its relationship with techne and precision medicine using PubMed and Google Scholar and the Standford Encyclopedia of Philosophy to search for the following keywords singularly or in combination: “Canguilhem”, “techne”, “episteme”, “precision medicine”, “machine learning AND medicine”. Results The Hippocratic concept of techne accounts for many characteristics of medical knowledge and practice. The advances of biomedicine, experimental medicine and, more recently, machine learning offer, in contrast, the model of a medicine based purely on episteme. I argue that Canguilhem medical epistemology establishes a framework where episteme and data-driven medicine is compatible with the promotion of patient’s autonomy and self-normativity. Conclusions Canguilhem’s medical epistemology orders the relationship of applied medicine with experimental sciences, ethics and social sciences. It provides guidance to define the scope of medicine and the boundaries of medicalization of healthy life. Finally, it sets an agenda for a safe implementation of machine learning in medicine. (shrink)

Much of the discussion of the role of emerging technologies associated with AI, machine learning, digital simulacra, and relevant ethical considerations such as those discussed in the target article, take a relatively narrow and episodic view of a person’s healthcare needs. There is much speculation about diagnostic, treatment, and predictive applications but relatively little consideration of how such technologies might be used to address a person’s lived experience of illness and ongoing care needs. This is likely due to the (...) greater weight or priority given to acute care needs and the role of medical treatment in care provision, but it may also reflect the limitations of current technologies and our limited vision of their potential application. Such limitations are not surprising given that we are still grappling with the complexities and nuances of achieving the ethical and humanistic ideals of care, namely, care that addresses the hermeneutical, relational, contextual, temporal, and agential dimensions of a person’s health and wellbeing. (shrink)

The Joy of Not Knowing takes every aspect of the curriculum and of school life and transforms it into a personalised, meaningful and enjoyable experience for all. It offers readers an innovative, theoretical and practical guide to establish a values-based, enquiry-led and challenge-rich learning to learn approach to teaching and learning and to school leadership. This thought-provoking guide provides the reader with a wealth of whole-class, easy-to-implement, malleable, practical ideas and case studies that can be personalised (...) to the vision of each setting, age-group and curriculum. It brings together, as a whole-school framework, the strategies that have been shown to have the greatest impact on practitioner's professional fulfilment and on children's life chances, love of learning, intrinsic motivation and enthusiasm for wanting to know. The Joy of Not Knowing: enables schools to launch the academic year with a bespoke JONK Learning to Learn Week that enables every student to succeed; develops philosophical, creative and critical problem-solving and multi-lingual thinking skills; establishes collaborative cultures of thinking, learning and leadership; Informs practice through active action research; incorporates a values-led democratic approach to school life; nurtures school-pupil-family-community partnerships. Designed for school leaders and practitioners at all levels and across all ages, this practical guide shows how all students can thrive and develop the dispositions of successful lifelong learners and global citizens. (shrink)

Education at all levels is increasingly augmented and enhanced by data mining and analytics, catalysed by the growing prevalence of automated distance learning. With an unprecedented capacity to scale both horizontally and vertically, data mining and analytics are set to be a transformative part of the future of education. We reflect on the assumptions behind data mining and the potential consequences of learning analytics, with reference to an issue brief prepared for the U.S. Department of Education entitled Enhancing (...) Teaching and Learning Through Educational Data Mining and Learning Analytics. We argue that the associated gains conceal subtle, but important risks. Data-ism, an underpinning paradigm, assigns unjustified veracity to data-driven science and the application of personalised analytics may compromise individual privacy, agency and inventiveness. This holds serious ethical implications, particularly when considering the impact on minors, rendering wholesale adoption premature. (shrink)

This paper will explore the power of history in affecting contemporary caring practice. Drawing on the author's personal experience as a social worker, researcher and parent of a daughter with learning disabilities, the article will consider the ways in which the experience of (and to an extent, nostalgia for) the ?heady days? of de-institutionalisation continues to influence staff perceptions about their work. In doing so, this article will critique normative notions of choice and control that are at the heart (...) of current moves towards self-directed support and personalised services. The author contends that staff who support people who have learning disabilities need something with which to compare and validate their practice. In the 1980s the hospitals were easily identifiable as something negative with which practice ?in the community? could be compared. In the twenty-first century the need for a comparator is still there, but the hospitals and many of their associated structures such as Adult Training Centres have gone. The paper argues that the family can be a contemporary structure against which current practice can be measured. (shrink)

PurposeChange is the operative word in higher education; as roles shift, classrooms are reinvented, and content becomes increasingly more accessible. At the core of these changes is the pervasiveness of learning technology. This papers aims to propose a model for the selection and adoption of emerging learning technologies to enhance learning within the context of higher education.Design/methodology/approachHigher education institutions are resorting to the deployment of learning technologies to address the demands of the twenty-first century learners and (...) to ascertain their competitiveness. This paper draws from the literature to provide a model, composed of five key characteristics of learning, to support the selection and adoption of emerging learning technologies.FindingsThe model posits that the attainment of each of these five characteristics, personalised, ubiquitous, collaborative, lifelong and authentic needs to be supported by corresponding technologies: adaptive learning technologies, artificial intelligence, mobile technology, social technology, massive open online courses, virtual and augmented reality, gamification and the Internet of Things.Originality/valueHigher education is progressively being displaced from the traditional classroom, and as it progresses towards online settings, it requires the support of technology to facilitate that transference. In examining the potential of future learning technologies, this paper contributes to a growing body of research that focuses on the benefits of technology within higher education and assists educators in the selection and adoption of the most relevant technologies. (shrink)

Building a biobank network in developing countries is essential to foster genomic research and precision medicine for patients’ benefit. However, there are serious barriers to establishing biobanks in low-income and middle-income countries (LMICs), including Ukraine. Here, we outline key barriers and essential milestones for the successful expansion of biobanks, genomic research and personalised medicine in Ukraine, drawing from the experience of other LMICs. A lack of legal and ethical governance in conjunction with limited awareness about biobanking and community distrust (...) are the principal threats to establishing biobanks. The experiences of LMICs suggest that Ukraine urgently needs national guidelines covering ethical and legal aspects of biospecimen-related research. National guidelines must be consistent with international ethical recommendations for safeguarding participants’ rights, welfare and privacy. Additionally, efforts to educate and engage physicians and patient communities are essential for achieving biobanking goals and benefits for precision medicine and future patients. (shrink)

Lifelong learning is something which one does for oneself that no one else can do for one: it is a public and personal human activity, rather than private or individualistic. One of the features of the education system is the paucity of a language for learning as process and participative experience. Personalised learning requires a sense of the worth-whileness of 'being a learner' - a virtue in the 21st century. A sense of one's own worth as (...) a person is essential to understanding one's identity as a learner. Research suggests the human capacity to learn can be understood as a form of consciousness which is characterised by particular values, attitudes and dispositions, with a lateral and a temporal connectivity. This 'consciousness' has several dimensions which are all related to becoming a person, with a learning identity. They also enable the learner to become aware of and appropriate what is of worth and map onto the sorts of core values that learning communities espouse. Awareness of self and of one's own worth as a person is a necessary condition for 'becoming a learner' and for identifying and engaging with 'what is of worth'. Furthermore, a sense of self as a learner is formed in relationship, and understood as one learns to tell one's own story, as a participant in the conversation of the learning community. Character is the way in which we refer to that quality of personhood in which there is rooted the capacity to change and learn over time. (shrink)

Objective: Mindfulness-based intervention has been proposed to alleviate loneliness and improve social connectedness. Several randomized controlled trials have been conducted to evaluate the effectiveness of MBI. This study aimed to critically evaluate and determine the effectiveness and safety of MBI in alleviating the feeling of loneliness.Methods: We searched Medline, Embase, PsycInfo, Cochrane CENTRAL, and AMED for publications from inception to May 2020. We included RCTs with human subjects who were enrolled in MBI with loneliness as an outcome. The quality of (...) evidence was assessed using Cochrane's Risk of Bias tool and Grading of Recommendations Assessment, Development, and Evaluation. A random-effects model was used for meta-analysis.Results: Out of 92 articles identified, eight studies involving 815 participants were included in this study. Most trials conducted a minimum of 8 weeks of MBI. Most of the trials used UCLA-Loneliness Scale. A pooled analysis combining three trials and compared with wait-list showed significant improvement in loneliness score reduction using the UCLA-R scale with MD of −6.33 [95% confidence interval : −9.39, −3.26]. Subgroup analysis with only two Cognitively-Based Compassion Training trials also showed similar MD of −6.05. The overall quality of evidence was low.Conclusions: Mindfulness intervention with an average length of 8-week duration significantly improved the population's loneliness level with no mental health issue. However, this evidence had a low GRADE level. (shrink)

The language of self‐belief, including terms like shyness and diffidence, is complex and puzzling. The idea of self‐esteem in particular, which has been given fresh currency by recent interest in ‘personalised learning’, continues to create problems. I argue first that we need a ‘thicker’ and more subtle moral psychology of self‐belief; and, secondly, that there is a radical instability in the ideas and concepts in this area, an instability to which justice needs to be done. I suggest that (...) aspects of deconstruction are helpful here, and offer a deconstructive reading of Kipling's poem, If—, in order to illustrate the power of literature and a certain kind of philosophy to destabilise and resist closure. (shrink)

The language of self-belief, including terms like shyness and diffidence, is complex and puzzling. The idea of self-esteem in particular, which has been given fresh currency by recent interest in ‘personalised learning’, continues to create problems. I argue first that we need a ‘thicker’ and more subtle moral psychology of self-belief; and, secondly, that there is a radical instability in the ideas and concepts in this area, an instability to which justice needs to be done. I suggest that (...) aspects of deconstruction are helpful here, and offer a deconstructive reading of Kipling’s poem, If—, in order to illustrate the power of literature and a certain kind of philosophy to destabilise and resist closure. (shrink)

The language of self-belief, including terms like shyness and diffidence, is complex and puzzling. The idea of self-esteem in particular, which has been given fresh currency by recent interest in ‘personalised learning’, continues to create problems. I argue first that we need a ‘thicker’ and more subtle moral psychology of self-belief; and, secondly, that there is a radical instability in the ideas and concepts in this area, an instability to which justice needs to be done. I suggest that (...) aspects of deconstruction are helpful here, and offer a deconstructive reading of Kipling’s poem, If—, in order to illustrate the power of literature and a certain kind of philosophy to destabilise and resist closure. (shrink)

I analyse an argument according to which medical artificial intelligence represents a threat to patient autonomy—recently put forward by Rosalind McDougall in the Journal of Medical Ethics. The argument takes the case of IBM Watson for Oncology to argue that such technologies risk disregarding the individual values and wishes of patients. I find three problems with this argument: it confuses AI with machine learning; it misses machine learning’s potential for personalised medicine through big data; it fails to (...) distinguish between evidence-based advice and decision-making within healthcare. I conclude that how much and which tasks we should delegate to machine learning and other technologies within healthcare and beyond is indeed a crucial question of our time, but in order to answer it, we must be careful in analysing and properly distinguish between the different systems and different delegated tasks. (shrink)

Healthcare systems across the globe are struggling with increasing costs and worsening outcomes. This presents those responsible for overseeing healthcare with a challenge. Increasingly, policymakers, politicians, clinical entrepreneurs and computer and data scientists argue that a key part of the solution will be ‘Artificial Intelligence’ (AI) – particularly Machine Learning (ML). This argument stems not from the belief that all healthcare needs will soon be taken care of by “robot doctors.” Instead, it is an argument that rests on the (...) classic counterfactual definition of AI as an umbrella term for a range of techniques that can be used to make machines complete tasks in a way that would be considered intelligent were they to be completed by a human. Automation of this nature could offer great opportunities for the improvement of healthcare services and ultimately patients’ health by significantly improving human clinical capabilities in diagnosis, drug discovery, epidemiology, personalised medicine, and operational efficiency. However, if these AI solutions are to be embedded in clinical practice, then at least three issues need to be considered: the technical possibilities and limitations; the ethical, regulatory and legal framework; and the governance framework. In this article, we report on the results of a systematic analysis designed to provide a clear overview of the second of these elements: the ethical, regulatory and legal framework. We find that ethical issues arise at six levels of abstraction (individual, interpersonal, group, institutional, sectoral, and societal) and can be categorised as epistemic, normative, or overarching. We conclude by stressing how important it is that the ethical challenges raised by implementing AI in healthcare settings are tackled proactively rather than reactively and map the key considerations for policymakers to each of the ethical concerns highlighted. (shrink)

Information we use to structure our lives is increasingly stored digitally, rather than in biomemory. (Just think: if your online calendar went down, would you know where you are supposed be and at what time next week?) Likewise, with breakthroughs such as those from Google DeepMind and OpenAI, discoveries at the frontiers of knowledge are increasingly due to machine learning (often, applied to massive datasets, extracted from a fast-growing datasphere) rather than to brainbound cognition. It’s hard to deny that (...) knowledge retention and production is becoming increasingly – in various ways – digitised. -/- Digital Knowledge: A Philosophical Investigation is the first book to squarely and rigorously investigate digital knowledge: what it is, how to make sense of it in connection with received theories of knowledge, and where it is going. Key questions J Adam Carter examines along the way are the following: -/- How is mere digital information converted into reliable digital knowledge? To what extent can digital knowledge be vindicated against sceptical challenges, and in what ways might digital knowledge stand distinctively subject to defeat? What is the epistemically optimal way for us to decide which tasks to outsource entirely to intelligent machines, and to what extent is further outsourcing appropriate (or not) to verify the results of that same outsourced cognition? Are there any ways in which the expansion of the datasphere threatens to make knowledge more, rather than easy, to come by? If so, are there any promising ways to safeguard, epistemically, against such threats? Using fascinating examples throughout, such as the recent chess match between Stockfish and Google’s AlphaZero, smartphones and personalisation, Digital Knowledge: A Philosophical Investigation is an ideal for researchers investigating this fascinating area of research at the intersection of traditional mainstream epistemology, the philosophy of cognitive science, the philosophy of technology, and computer science. (shrink)

The prevalence of overweight and obesity in young adults has increased dramatically in recent decades. The unhealthy eating habits that develop at this time can often lead to negative health consequences in the future. It is therefore important to learn about self-regulation and self-control strategies and help young adults to have healthy eating behaviours. This study aims to present an Italian version of the Tempest Self-Regulation Questionnaire for Eating adapted for young adults. The instrument assesses self-regulation and self-control strategies to (...) counteract the desire and temptation to eat unhealthy food and to choose healthy foods. A total of 645 students took part in the study. The results of the confirmatory factor analysis supported the six first-order factors model concerning specific self-regulation strategies and a higher-order structure of the TESQ-E [χ2 = 336.480, p < 0.001; CFI = 0.95; RMSEA = 0.04; SRMR = 0.04]: three correlated second-order factors and one-third-order factor. The results also confirmed the strong measurement invariance of the TESQ-E across gender. To have reliable comparisons across males and females, the latent mean differences tests were performed on the six specific self-regulation strategies. The analysis showed that females appear to prefer strategies that directly address the goal by expressing explicit intentions or plans to eat in a healthy way. Convergence validity was tested through correlations with Eating-Self-Efficacy Brief Scale, Emotional Eating Scale, Scale of Attitudes towards Healthy Eating, and Body Mass Index. In conclusion, the TESQ-E appears to be a psychometrically sound questionnaire that can be effectively used with young adults to measure self-regulation strategies in eating in order to plan personalised interventions for the prevention and control of the metabolic syndrome, and to reduce a wide range of diet-related diseases. (shrink)

Higher education in the 21st century faces the challenge of changing the way in which knowledge is conveyed and how teachers and students interact in the teaching-learning process. The current pandemic caused by SARS-CoV-2 has hastened the need to face up to this challenge and has furthered the need to approach the issue from the perspective of digitalisation. To achieve this, it is necessary to design training programmes geared towards teaching staff and which address both the use of technology (...) and instructional design aimed at promoting the development of self-regulated learning and automatic feedback systems. In this study, work was carried out with 23 teachers in a training programme conducted through Moodle. The aims were: to test whether there were any significant differences between the behaviour patterns of new teachers compared to experienced teachers, to determine whether clusters of behaviour patterns corresponded to the type of teacher and to ascertain whether the level of teacher satisfaction with the training activity in digital teaching will depend on the type of teacher. A quantitative as well as a qualitative design was applied. Differences were found in the behaviour patterns in the training activities for the development of rubrics and use of learning analytics systems in virtual learning environments. It was also found that the type of teacher did not correspond exactly to the behaviour cluster in the learning platform. In addition, no significant differences were found in the level of satisfaction between the two kinds of teacher. The main contribution this study makes is to provide a detailed description of the training stage as well as the materials required for its repetition. Further analytical studies are required on teacher perception of training programmes in digital teaching in order to provide personalised training proposals that lead to an effective use of teaching in digital environments. (shrink)

In recent years we have seen the emergence of “personalised medicine.” This development can be seen as the logical product of reductionism in medical science in which disease is increasingly understood in molecular terms. Personalised medicine has flourished as a consequence of the application of neoliberal principles to health care, whereby a commercial and social need for personalised medicine has been created. More specifically, personalised medicine benefits from the ongoing commercialisation of the body and of genetic (...) knowledge, the idea that health is defined by genetics, and the emphasis the state places on individual citizens as being “responsible for” their own health. In this paper I critique the emergence of personalised medicine by examining the ways in which it has already impacted upon health and health care delivery. (shrink)

This is a volume of twelve essays concerning the fundamental tension in personalised medicine between individual choice and the common good.

Issues of reliability are claiming center-stage in the epistemology of machine learning. This paper unifies different branches in the literature and points to promising research directions, whilst also providing an accessible introduction to key concepts in statistics and machine learning – as far as they are concerned with reliability.

Technological advances are bringing new light to privacy issues and changing the reasons for why privacy is important. These advances have changed not only the kind of personal data that is available to be collected, but also how that personal data can be used by those who have access to it. We are particularly concerned with how information about personal attributes inferred from collected data (such as online behaviour), can be used to tailor messages and services to specific individuals or (...) groups. This kind of ‘personalised targeting’ has the potential to influence individuals’ perceptions, attitudes, and choices in unprecedented ways. In this paper, we argue that because it is becoming easier for companies to use collected data for influence, threats to privacy are increasingly also threats to personal autonomy—an individual’s ability to reflect on and decide freely about their values, actions, and behaviour, and to act on those choices.4 While increasing attention is directed to the ethics of how personal data is collected, we make the case that a new ethics of privacy needs to also think more rigorously about how personal data may be used, and its potential impact on personal autonomy. (shrink)

Rather than seek to distinguish hype from legitimate promise, it may be more helpful to think about personalised medicine as embodying a promissory economy which serves both to mobilize resources for research and — partly at least — to determine the ends to which that research is directed. Personalised medicine is a development of the larger promissory economy of medical biotechnology. As such, it systematically conflates public benefit with the pursuit of commercial and especially pharmaceutical interests. Consequently, research (...) and development in personalised medicine tends to favour the production of expensive new treatments over unprofitable forms of prevention or more effective use of older therapies. A rebalancing of research priorities is needed to favour the pursuit of public benefit, even when it does not deliver private profits. This will in turn require sustained reflection, self-criticism and often self-denial on the part of public research funders and the scientists they support. (shrink)

Die öffentliche Diskussion um die „personalisierte Medizin“ legt nahe, dass mit diesem medizinischen Ansatz hohe Erwartungen an einen Beitrag zur klinischen Versorgung verbunden werden. Über die Wahrnehmungen und Bewertungen klinisch tätiger Ärzte ist jedoch wenig bekannt. Die vorliegende qualitative Interviewstudie gibt einen Einblick bezüglich des Einflusses „personalisierter Medizin“ auf die klinische Praxis aus ärztlicher Perspektive. Die Ärzte im vorliegenden Sample nehmen „personalisierte Medizin“ zwar als einen medizinischen Fortschritt wahr, sehen allerdings keine grundsätzliche Veränderung der bisherigen medizinischen Praxis. Als zentrales Problem (...) wird die Handhabung und Verwertung von molekulargenetischen Informationen für Diagnose und Therapie in der klinischen Praxis thematisiert. In Anbetracht der Ergebnisse muss infrage gestellt werden, ob „personalisierte Medizin“ nicht das Gegenteil von dem, was ihr Name nahe legt – eine personenorientiertere Medizin – bewirkt. Die Strategien im Umgang mit den Informationsmassen produzieren selbst neue Herausforderungen, die ein Hindernis für eine personenorientierte Medizin darstellen könnten. (shrink)

Developments in the provision of care and support services for disabled and older people across developed welfare states have led to the expansion of personalisation (sometimes called cash-for-care, direct payments, care payments, etc.) schemes, whereby cash is paid in substitute for care services and support. Although these schemes vary considerably in their scope and operation (sometimes paying carers directly, sometimes enabling disabled and older people to act as direct employers, sometimes mixing paid and unpaid care), they share the characteristics of (...) commodifying care and support services and will have a potentially profound impact on the relationship between individuals, families, communities and the welfare state. Although the schemes have been evaluated within their own national contexts, little work has been done so far to explore the theoretical implications of their development and extension, particularly from an ethics of care perspective. This paper intends to fill that theoretical gap by drawing on comparative evidence from several schemes across different national contexts to develop an analysis which draws on feminist theory and an ethics of care approach to examine (a) the gendered policy outcomes and impact of such schemes; (b) a feminist analysis of the governance implications of personalisation; (c) the implications for the gendered division of work, particularly between paid and unpaid care work and between different groups of paid and unpaid carers; (d) an ethics of care analysis of the impact of personalisation over the lifecourse of disabled and older people, and carers; and (e) a discussion of the relationship between commodification, empowerment, citizenship and choice drawing on the work of care ethicists. It will draw conclusions about the outcomes of a range of types of personalisation schemes and thus have implications for theory, policy and practice. (shrink)

In interviews, it may happen that a respondent gives an answer which seems well formatted, but is not receipted as acceptable by the interviewer. In this article I examine one way in which interviewers display their diagnosis of the problem and act to bring about its solution. In the cases I describe, the interviewers defer revision of the question until they have established a new, more personalized basis for it, informed by their knowledge of the respondents' circumstances. There are three (...) things of interest. The first is how this actually works conversationally; it seems to be structured as an insertion sequence and played out by presequential turns which are highly projective of the respondent's agreement. The second is that the scenario that the interviewer inserts is a positive example of what would have been an answer to the `failed' original question. The third is that there is a difference between the original, general question and its subsequent, specific revision. I argue that all these features manifest interviewers' solution of their dilemma in choosing between literal and sensitive questioning. (shrink)

Learning is fundamentally about action, enabling the successful navigation of a changing and uncertain environment. The experience of pain is central to this process, indicating the need for a change in action so as to mitigate potential threat to bodily integrity. This review considers the application of Bayesian models of learning in pain that inherently accommodate uncertainty and action, which, we shall propose are essential in understanding learning in both acute and persistent cases of pain.

The idea of personalised medicine (PM) has gathered momentum recently, attracting funding and generating hopes as well as scepticism. As PM gives rise to differing interpretations, there have been several attempts to clarify the concept. In an influential paper published in this journal, Schleidgen and colleagues have proposed a precise and narrow definition of PM on the basis of a systematic literature review. Given that their conclusion is at odds with those of other recent attempts to understand PM, we (...) consider whether their systematic review gives them an edge over competing interpretations. We have found some methodological weaknesses and questionable assumptions in Schleidgen and colleagues’ attempt to provide a more specific definition of PM. Our perplexities concern the lack of criteria for assessing the epistemic strength of the definitions that they consider, as well as the logical principles used to extract a more precise definition, the narrowness of the pool from which they have drawn their empirical data, and finally their overlooking the fact that definitions depend on the context of use. We are also worried that their ethical assumption that only patients’ interests are legitimate is too simplistic and drives all other stakeholders’ interests—including those that are justifiable—underground, thus compromising any hope of a transparent and fair negotiation among a plurality of actors and interests. As an alternative to the shortcomings of attempting a semantic disciplining of the concept we propose a pragmatic approach. Rather than considering PM to be a scientific concept in need of precise demarcation, we look at it as an open and negotiable concept used in a variety of contexts including at the level of orienting research goals and policy objectives. We believe that since PM is still more an ideal than an achieved reality, a plurality of visions is to be expected and we need to pay attention to the people, reasons and interests behind these alternative conceptions. In other words, the logic and politics of PM cannot be disentangled and disagreements need to be tackled addressing the normative and strategic conflicts behind them. (shrink)

Just as humans can draw conclusions responsibly or irresponsibly, so too can computers. Machine learning systems that have been trained on data sets that include irresponsible judgments are likely to yield irresponsible predictions as outputs. In this paper I focus on a particular kind of inference a computer system might make: identification of the intentions with which a person acted on the basis of photographic evidence. Such inferences are liable to be morally objectionable, because of a way in which (...) they are presumptuous. After elaborating this moral concern, I explore the possibility that carefully procuring the training data for image recognition systems could ensure that the systems avoid the problem. The lesson of this paper extends beyond just the particular case of image recognition systems and the challenge of responsibly identifying a person’s intentions. Reflection on this particular case demonstrates the importance (as well as the difficulty) of evaluating machine learning systems and their training data from the standpoint of moral considerations that are not encompassed by ordinary assessments of predictive accuracy. (shrink)

Personalised medicine has been discussed as a medical paradigm shift that will improve health while reducing inefficiency and waste. At the same time, it raises new practical, regulatory, and ethical challenges. In this paper, we examine PM strategies epistemologically in order to develop capacities to address these challenges, focusing on a recently proposed strategy for developing patient-specific models from induced pluripotent stem cells so as to make individualised treatment predictions. We compare this strategy to two main PM strategies—stratified medicine (...) and computational models. Drawing on epistemological work in the philosophy of medicine, we explain why these two methods, while powerful, are neither truly personalised nor, epistemologically speaking, novel strategies. Both are forms of correlational black box. We then argue that the iPSC models would count as a new kind of black box. They would not rely entirely on mechanistic knowledge, and they would utilise correlational evidence in a different way from other strategies—a way that would enable personalised predictions. In arguing that the iPSC models would present a novel method of gaining evidence for clinical practice, we provide an epistemic analysis that can help to inform the practical, regulatory, and ethical challenges of developing an iPSC system. (shrink)

The adoption of Big Data analytics in insurance has proved controversial but there has been little analysis specifying how insurance practices are changing. Is insurance passively subject to the forces of disruptive innovation, moving away from the pooling of risk towards its personalisation or individualisation, and what might that mean in practice? This special theme situates disruptive innovations, particularly the experimental practices of behaviour-based personalisation, in the context of the practice and regulation of contemporary insurance. Our contributors argue that behaviour-based (...) personalisation in insurance has different and broader implications than have yet been appreciated. BDAs are changing how insurance governs risk; how it knows, classifies, manages, prices and sells it, in ways that are more opaque and more extensive than the black boxes of in-car telematics. (shrink)